Differences in HPV Immunization Levels Among Young Adults in Various Regions of the United States.

HPV vaccine uptake in young adult women in the Southern US has been previously found to be the lowest in the country. In addition, geographic variation with regard to HPV vaccination among young adult men has not been investigated yet. The objective of this study was to use the most recent data to determine if inequality still exists. We used Behavioral Risk Factor Surveillance System 2012 data from 8 states (no data available from Midwest) to examine the geographic variations in weighted proportion of adults who initiated (≥ 1 dose) and completed (3 doses) the HPV vaccine among 3727 young adults (2014 women and 1713 men) 18-26 years old based on self-reported HPV vaccination and socio-demographic characteristics. The weighted vaccine initiation and completion rates among men were: 6.3 and 1.7% overall, 8.5 and 2.2% in the Northeast, 6.7 and 1.6% in the West, and 4.9 and 1.4% in the South (p = 0.184 and 0.774). The rates among women were: 40.4% and 27.4, 58.7 and 45.6%, 39.0 and 24.8%, and 30.4 and 17.7% in the respective regions (p < 0.001 for both). Adjusted multivariable logistic regression showed that women living in the South and West were less likely to initiate and complete the 3-dose HPV vaccine series when compared to those in the Northeast. Despite an increase in HPV vaccine uptake among young adult women in all regions, geographic disparity still exists. Moreover, young adult men had very low HPV vaccine initiation and completion rates throughout the US.